The present disclosure relates generally to airway access adapters used in respiratory applications. More particular, it relates to adapters and related closed suction catheter systems with enhanced cleaning or flushing capabilities, as well as optional valve configurations useful therewith.
Use of ventilators and related breathing circuits to assist in patient breathing is well known in the art. For example, during surgery and other medical procedures, the patient is often connected to a ventilator to provide respiratory gases to the patient. In many instances, the mechanical ventilation is connected into the patient's respiratory tract via an artificial airway, such as a tracheostomy tube, endotracheal tube, etc.
While the breathing circuit can establish a single, direct fluid connection between the ventilator and the artificial airway, in many instances, caregivers desire the ability to introduce instruments and/or materials into the breathing circuit. To satisfy these needs, airway access adapters have been developed. In general terms, an airway access adapter is a manifold-type body providing at least three fluidly connected ports including a ventilator port, a respiratory port, and an access port. During use, the airway access adapter is assembled to the breathing circuit with the ventilator fluidly connected to the ventilator port and the artificial airway fluidly connected to the respiratory port. With this configuration, the access port enables caregivers to, for example, insert instruments for visualization or related procedures, or to aspirate fluid or secretions from the patient's airway. Typically, the airway access adapter provides a seal or valve configuration across the access port so that pressures required to maintain ventilation of the patient are not lost via the access port. Airway access adapters are well accepted, and are highly beneficial especially with patients requiring long-term mechanical ventilation.
As indicated above, the airway access adapter facilitates use of a variety of different tools within the breathing circuit. One such tool is a closed suction catheter system used to remove secretions or fluids from the airways of a ventilated patient. To prevent loss of ventilating pressures, the catheter is made part of the sealed breathing circuit so that the circuit does not need to be “opened” in order to suction the patient's airways. Additionally, so that the catheter can remain uncontaminated by environmental micro-organisms, or contaminated by caregivers, the closed suction catheter system oftentimes includes a sheath that covers the portion of the catheter outside the breathing circuit. With this configuration, the closed suction catheter system can be left attached to the breathing circuit (via the airway access adapter) between suctioning procedures. Over time, however, secretions and other materials may accumulate at the working end of the catheter, necessitating periodic cleaning of the catheter. One common cleaning approach entails flushing the catheter end with a fluid such as saline or water to maintain patency and to prevent a stagnation of a media for bacterial growth.
Existing closed suction catheter systems and related airway access adapters employ one of two configurations that enable flushing of the suction catheter system. With one approach, the suction catheter is readily removed from the airway access adapter, and incorporates a flush port otherwise attached to the suction catheter components that facilitates cleaning. With this approach, the flush port is removed from the airway access adapter along with other components of the suctioning catheter system. Conversely, where the suction catheter system (and related airway access adapter) is solely for closed suction applications (i.e., the catheter cannot be detached from the airway access adapter), a flush port is provided with the airway access adapter itself. Since the catheter cannot be removed, the flush port is located so as to introduce the cleaning fluid near the tip of the catheter when the catheter is fully withdrawn from the patient's airway and into the protective sheath.
While the two suction catheter cleaning configurations described above are highly useful, certain drawbacks remain. With removable catheter/flush port designs, other instruments passed into the access port of the airway access adapter (following the removal of the closed suction catheter system) are not easily cleaned. That is to say, once the flush port is removed, it is no longer available for facilitating cleaning of other instruments. Conversely, with available airway access adapters incorporating a flush port, the suction catheter is not readily removed, and cannot be replaced with other instruments, thus limiting an overall usefulness of the adapter. Along these same lines, modifying an airway access adapter having a flush port to removably accept a suction catheter (via a slip fit seal) would result in the slip fit seal blocking the flush port, and thus is not viable.
In addition to the drawbacks associated with current flush port configurations, airway access adapters commonly include a valve of some type that closes the access port during periods of non-use, and promotes sealed insertion of various instruments therethrough. In this regard, conventional check valves and/or flap valves are widely employed, but long-term, repeated sealing of the valve is less than optimal.
In light of the above, needs exist for improved airway access adapters as well as closed suction catheter systems used therewith.